Columbus Neighborhood Health Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Columbus, OH

NPI 1497817142 · NPPES record last updated Aug 28, 2026

Key facts

NPI
1497817142
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
COLUMBUS NEIGHBORHOOD HEALTH CENTER INC
Practice address
2300 W Broad St
Columbus, OH 43204-3783
Phone
(614) 645-2300
Fax
(614) 645-2333
NPI assigned
Dec 15, 2006
Organization subpart
Yes
Parent organization (as reported)
COLUMBUS NEIGHBORHOOD HEALTH CENTER INC

Authorized official

Name
Johnetta Ridgeway
Title
Provider Enrollment Coordinator
Phone
(614) 859-1906

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 119

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 119

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0328844Columbus Neighborhood Health
2300 West Broad Street, Columbus, OH 43204
Provider-performed microscopyAug 31, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OH

Federally qualified health center certification: CCN 361871

Legal name
COLUMBUS NEIGHBORHOOD HEALTH CENTER INC
Doing business as
PRIMARYONE HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1998
Last certification
Jan 1, 1998
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
2300 West Broad Street
Columbus, OH 43204-3783

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nichole Otayco
Individual
Corporate Officer
Coo
Dec 10, 2024
Jennifer Beard
Individual
Corporate Director
Board Member
Feb 22, 2022
Liza Paul
Individual
Corporate Director
Board of Director
Jun 17, 2024
Johnetta Ridgeway
Individual
W-2 Managing Employee
Provider Enrollment Specialist
Feb 22, 2022
Caitlin Purk
Individual
Corporate Director
Board of Director Member
Jun 14, 2024
Eric Wu
Individual
Corporate Director
Board of Director
Jun 14, 2024
Ephraim Laidley
Individual
Corporate Director
Board of Director Member
Jun 14, 2024
Emily Fisher
Individual
Corporate Director
Board Member
Feb 22, 2022
Robert Weis
Individual
Corporate Director
Cfo
Dec 10, 2024
Dustin McKee
Individual
Corporate Director
Board Member
Feb 22, 2022
Adrian Fredrick
Individual
Corporate Director
Board of Director Member
Jun 14, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110713000867 OH Part a Provider - Federally Qualified Health Center (FQHC) 3678469129 Practice locations: Columbus, OH
O20140721000618 OH Part B Supplier - Clinic/Group Practice 3678469129 Receives reassigned benefits from 120 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Circleville, OH

National Provider Directory

Tax ID family
CNHC St Marks Health CT (19 organizations share this tax ID)

Locations

1751 Alum Creek Dr
Columbus, OH 43207
Phone (614) 526-5420

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

2300 W Broad St
Columbus, OH 43204-3783

Mailing address

3433 Agler Rd Ste 2800
Columbus, OH 43219-3389
Phone (614) 859-1906

Other identifiers

IdentifierTypeStateIssuer
36D0328844OtherOHCLIA
2051176MedicaidOH

Other names

  • PrimaryOne Health Doing business as

Other providers in Columbus, OH

All providers in Columbus, OH · Federally Qualified Health Center (FQHC) in Ohio

Sources for this page

Verify at the official NPI Registry.